HEALTH DELIVERY REFORM IN NEW ZEALAND: WHAT DOES IT MEAN TO POLICY ACTORS? = HEALTH DELIVERY REFORM IN NEW ZEALAND: WHAT DOES IT MEAN TO POLICY ACTORS?

다국어 초록 (Multilingual Abstract)

Purpose: To discover the experiences of primary health managers who have dealt with frequent changes in the health delivery framework. The changes have sometimes moved in contradictory directions. The effects of such changes on health managers have not been properly examined. A better understanding of this phenomenon would allow policy makers to encourage managerial commitment to emerging policies. Design/Methodology/Approach: A critical hermeneutic approach is employed to interpret evidence from government policy documents, and semi-structured interviews with health managers. Findings: Reforms have brought constant changes in public health governance, as well as its structure. Although some changes were major, the need for the reforms has generally been well accepted by the health policy actors; they have believed the reforms necessary to improve the efficiencies of the health systems. However, in terms of policy implementation, the health policy actors have expressed their bewilderment and concern over the policy changes and the way in which many of the reforms were implemented. Discussions: Although reforms were expected to bring about improvement to the quality of public health and government financial statements, in many instances the policy actors were caught up in the complexity of health structure and policy; this prevented the full potential benefits from materialising.